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  • What mainly set cellulitis apart from erysipelas are the skin layers or areas of the skin they affect
  • Erysipelas occurs in young children and older adults while cellulitis is found to occur more frequently among middle-aged individuals and older adults

Erysipelas Versus Cellulitis: What Sets These 2 Apart?


In some instances, cellulitis is often mistaken for another condition called erysipelas. These two are both acute and painful skin infections that may become potentially serious. They share similar characteristics, which is why they are often mistaken for the other.

Erysipelas and Cellulitis Are Closely Related

Both of these conditions usually start because of a minor incident, such as a cut, burn, wound or surgical incision. When bacteria enter your body through these openings, you may develop either cellulitis or erysipelas.

Usually, streptococci (specifically group A streptococci) bacteria are responsible for erysipelas. There are findings, however, that Klebsiella pneumoniae, Streptococcus pneumoniae, Yersinia enterocolitica Haemophilus influenzae type b and Moraxella spp. may cause erysipelas as well.1

On the other hand, cellulitis may also be caused by streptococci, but other types of bacteria, such as staphylococci, may lead to this condition. In some rare cases, fungi may be to blame for cellulitis.2

Both cellulitis and erysipelas are not contagious, as they affect the deeper layers of the skin. These two conditions are very different from impetigo, a superficial type of infection that can be easily passed from one person to another.3

Indeed, erysipelas and cellulitis appear to be very similar to each other. However, if you look closely, you will see that there are certain notable differences between these two infections.

What Are the Primary Differences Between These 2 Conditions?

What mainly set cellulitis apart from erysipelas are the skin layers or areas of the skin they affect.

If you have cellulitis, the infection is mostly found in the deep underlying tissues of your skin, including the deeper dermis and subcutaneous fat. Meanwhile, erysipelas affects the upper layers of the skin, or the upper dermis and superficial lymphatics.4

Another factor that distinguishes these two conditions is the age group that acquires them. Erysipelas occurs in young children and older adults. On the other hand, cellulitis is found to occur more frequently among middle-aged individuals and older adults (although children may also be at risk of it).5

Although both of these conditions can occur in any area of your body, cellulitis more commonly manifests in the lower legs, while true erysipelas likely appears in the legs and face — these are parts of the body where there is very little subcutaneous tissue.6,7 Patients with these conditions may also exhibit different symptoms. Here’s a comparison of the symptoms of these two illnesses:

Erysipelas Cellulitis
An abrupt onset of fever accompanied by chills You may experience a low-grade fever with a less abrupt onset
Dark-skinned people may have brownish-grey skin, while Caucasians may have bright red skin The skin appears brownish-black in dark skinned individuals, and dull red in Caucasians
The infected area is hot, tender and spreads; the surface is shiny but vesicles and bullae (fluid- or air-filled sacs or lesions) may form The border of the infected area is less well defined, and fades into the surrounding skin; you will not see any blisters or lesions
Pain and swelling commonly occur Pain and swelling commonly occur

Since skin involvement (how deep or which layers of the skin are affected by the infection) is the primary distinguishing factor of these two conditions, it is usually difficult for physicians to distinguish between cellulitis and erysipelas. Therefore, it is more ideal to consider erysipelas as “a cellulitis with superficial spread.”8

Consult a Physician to Get a Proper Diagnosis

Both cellulitis and erysipelas are diagnosed through their appearance and symptoms that a patient experiences. If you suspect that you may have either of these two conditions, consult a physician immediately to get a more definite diagnosis and to prevent complications from arising.

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